著者
土屋 欣之 野口 忠秀 篠崎 泰久 伊藤 弘人 神部 芳則 草間 幹夫
出版者
Japanese Society of Oral and Maxillofacial Surgeons
雑誌
日本口腔外科学会雑誌 (ISSN:00215163)
巻号頁・発行日
vol.58, no.2, pp.67-71, 2012
被引用文献数
3

A case of orbital abscess with gas gangrene due to odontogenic infection is reported. Although orbital abscesses are rare, they may result in fatal complications. A 68-year-old woman presented with pain and swelling of the left cheek and lower eyelid. She was unable to open her left eye. Oral examination revealed alveolar gingival swelling due to a periapical lesion of the left upper anterior tooth. Computed tomographic scans confirmed abscess formation in the left orbit and the presence of a gas bubble. The ocular tension was 50 mmHg. On admission to our hospital, the patient started to receive antibiotics (PAPM/BP and CLDM), the left lower eyelid was incised, and the abscess was successfully drained. <i>Alpha-streptococcus</i>, <i>coagulase-negative staphylococcus</i>, and <i>Prevotella melaniogenica</i> were detected in the suppuration. The patient was given a diagnosis of orbital abscess with gas gangrene due to odontogenic infection extending by way of the orbit.
著者
山田 利治 河原 康 佐野 大輔 渡邉 裕之 小澤 総喜 神谷 祐司
出版者
Japanese Society of Oral and Maxillofacial Surgeons
雑誌
日本口腔外科学会雑誌 (ISSN:00215163)
巻号頁・発行日
vol.54, no.4, pp.248-252, 2008-04-20
参考文献数
16
被引用文献数
2 1

We report a rare case of brain abscess secondary to mandibular odontogenic infection. A 50-year-oldman developed an abscess of the infratemporal fossa, masticatory myositis, and temporal myositis caused bylower first molar marginal periodontitis. Incision and drainage were performed by an intraoral approach, andantibiotics were administered intravenously. On the 8th disease day, vomiting occurred, but responded to anantiemetic drug. On the 9th disease day, extraction of lower first molar and adrasion was performed, resulting inthe alleviation of local symptoms. However, a persistent headache occurred, CT and MRI scans revealed a brainabscess and subdural abscess in the temporal lobe, immediately above the skull internal base. The patient wasgiven a diagnosis of brain abscess caused by odontogenic infection. The abscess almost disappeared after conservativetherapy administered at the department of brain surgery, and no sequelae were noted. The abscess apparentlyexpanded directly and continuously from the skull base through the foramen ovale and foramen spinosum.This case emphasizes the need to diagnose brain abscess and subdural abscess as complications of odontogenicinfection.
著者
新美 直哉 重冨 俊雄 大野 雄弘 小田 有紀子 水谷 英樹 上田 実
出版者
Japanese Society of Oral and Maxillofacial Surgeons
雑誌
日本口腔外科学会雑誌 (ISSN:00215163)
巻号頁・発行日
vol.47, no.2, pp.144-147, 2001-02-20
被引用文献数
5 1

Amyloid is defined as a pathologic fibrous proteinaceous substance which, when deposited between the cells of tissues and organs, leads to various clinical conditions. Immunohistochemistry has allowed for better classification and understanding of the pathophysiology of amyloidosis.<BR>A 70-year-old man was referred to our department because of spontaneous purpura of the skin and hematoma of the oral mucosa. There was no chemical or hematologic abnormality on routine examination. Bence Jones protein was positive in the urine. Bone marrow examination, however, revealed an slightly increased proportion of plasma cells. It was unlikely that the Bence Jones protein was associated with multiple myeloma. Skin biopsy revealed depositions of amyloid, and Congo red stain for amyloid was positive. In addition, immunofluoroecent staining resulted in a diagnosis of AA amyloidosis.<BR>The patient was treated with a combination of colchicine, melphalan, and prednisolone; however, 7 months after initial presentation he died of cardiac failure. Autopsy revealed multiple-organ vascular amyloidosis, and a diagnosis of bullous amyloidosis was made.
著者
小佐野 仁志 松本 浩一 野口 忠秀 草間 幹夫 櫻井 信司
出版者
Japanese Society of Oral and Maxillofacial Surgeons
雑誌
日本口腔外科学会雑誌 (ISSN:00215163)
巻号頁・発行日
vol.51, no.3, pp.136-139, 2005-03-20 (Released:2011-04-22)
参考文献数
14

A 76-year-old man presented with swelling of the right side of the maxilla. Spindle cell sarcoma was diagnosed on examination of a biopsy sample of the right maxillary sinus. We started CYVADIC (cyclophosphamide, vincristine, adriamycin, dacarbazin) chemotherapy. A favorable clinical response was obtained with 4 courses of chemotherapy. Partial resection of the maxilla was followed by 6 courses of CYVADIC therapy, because a small residual tumor was suspected. Histopathological examination revealed no residual tumor cells.Chemotherapeutic intervention appears to have been effective, with no apparent recurrence of lesions at present, 14 years after chemotherapy.
著者
岩井 恵理華 山本 泰 飯塚 普子 末光 正昌 久山 佳代 小宮 正道
出版者
公益社団法人 日本口腔外科学会
雑誌
日本口腔外科学会雑誌 (ISSN:00215163)
巻号頁・発行日
vol.67, no.11, pp.630-633, 2021-11-20 (Released:2022-01-20)
参考文献数
12

Dipeptidyl peptidase-4 (hereinafter referred to as DPP-4) inhibitors are used in diabetes therapy. They lower blood glucose by inhibiting DPP-4 and promoting insulin secretion. Here, we report a case of oral mucous membrane pemphigoid caused by the oral administration of a DPP-4 inhibitor. A 61-year-old female with gingival erosion and bleeding in the maxilla from the right first premolar to the left first premolar was referred to our department. On the first visit, redness, blisters, erosion, and the Nikolsky phenomenon were observed in the aforementioned region. A biopsy was performed for suspected pemphigoid. A histopathologicaldiagnosis of pemphigoid was obtained using HE staining and the fluorescent antibody method. The patient had diabetes and had been taking a combination drug containing vildagliptin (DPP-4 inhibitor) and metformin hydrochloride for two years and six months. We suspected that the pemphigoid was caused by the DPP-4 inhibitor. A request for a prescription modification was made to the internal medicine department, and the DPP-4 inhibitor was replaced with canagliflozin hydrate. The symptoms (redness, blisters, erosion, and the Nikolsky phenomenon) disappeared one month after suspension of the drug containing the DPP-4 inhibitor. Furthermore, relapse has not occurred in the 2 years since.
著者
青野 淳子 遊佐 浩 石上 敏幸 白土 貴之 鬼澤 浩司郎 吉田 廣
出版者
Japanese Society of Oral and Maxillofacial Surgeons
雑誌
日本口腔外科学会雑誌 (ISSN:00215163)
巻号頁・発行日
vol.48, no.3, pp.179-182, 2002-03-20 (Released:2011-04-22)
参考文献数
12

A rare case of osteomalacia with an oronasal fistula developing after sequestrectomy is presented. The patient was a 45-year-old woman who was referred to our hospital because of an intractable ulcer at the midline of the hard palate. She had an edentulous maxilla and wore a poorly fitting complete maxillary denture. Oral examination showed ulceration with a sequestrum under the prosthesis. Removal of the sequestrum extending from the oral cavity to the nostrils resulted in an oronasal fistula of the hard palate. The case was finally diagnosed as osteomalacia based on the results of radiographic and serum chemical examinations. In this patient, continuous pressure caused by the poorly fitting maxillary denture induced the sequestrum in the hard palate, which was thin and fragile because of osteomalacia.
著者
美島 健二
出版者
公益社団法人 日本口腔外科学会
雑誌
日本口腔外科学会雑誌 (ISSN:00215163)
巻号頁・発行日
vol.62, no.12, pp.592-601, 2016-12-20 (Released:2017-02-20)
参考文献数
35

The most common cancers in oral cavity are squamous cell carcinoma (OSSC), which accounts for more than 90% in oral cancers. The 5-year overall survival rate of early stage of OSCC is over 90%, while that of advanced stages is still poor. It is important to treat precancerous lesions including leukoplakia and erythroplakia to improve the prognosis. Malignant transformation rates of leukoplakia and erythroplakia range from 5% to 10% and 40% to 50%, respectively. Biopsy is performed to microscopically divide these lesions into oral intraepithelial neoplasia (OIN) /CIS and oral epithelial dysplasia. In addition to histological findings, immunohistochemical analysis such as Ki-67, p53, cytokeratin13, 17, and p16, is also helpful for the diagnosis. After surgical treatment, the resected specimens from OSCC patients are examined in details regarding prognostic factors, which are disease staging, resection margin free of diseases, tumor thickness, and extracapsular dissemination of lymph nodes. Furthermore, it is reported that EGFR-, NOTCH-, PI3K-, PTEN-and AKT-mediated pathways are involved in OSCC proliferation, suggesting that these factors can be expected to be promising molecular targets for OSCC treatment.
著者
野原 幹司 舘村 卓 和田 健 尾島 麻希 小谷 泰子 佐々生 康宏
出版者
Japanese Society of Oral and Maxillofacial Surgeons
雑誌
日本口腔外科学会雑誌 (ISSN:00215163)
巻号頁・発行日
vol.50, no.8, pp.455-460, 2004-08-20 (Released:2011-04-22)
参考文献数
23
被引用文献数
1

The purpose of this study was to examine whether the levator veli palatini muscle (LVP) in patients with velopharyngeal incompetence who have undergone surgery for cleft palate is more easily fatigued than that of normal subjects during speech. Five patients with postsurgical cleft palate who were identified to have borderline velopharyngeal incompetence on nasopharyngeal fiberscopy were studied. Five normal subjects served as control. Each subject was asked to pronounce/pu/more than 50 times at a rate of one time per second. Electromyograms (EMG) of the LVP were recorded at a sampling rate of 2000/sec. The mean power frequency (MPF) of one syllable was obtained by power spectral analysis with an analytic window 1 second in width. In all normal subjects, the slopes of the regression line relating the MPF of the LVP EMG to the syllable number were slightly, but not significantly negative. However, in all patients with borderline velopharyngeal incompetence, the slopes of the regression line were significantly negative. These findings revealed that the LVP of speakers with borderline velopharyngeal incompetence was more easily fatigued than that of normal speakers during repetition of syllables. This study suggests that the fatigability of the LVP might be one cause of borderline velopharyngeal incompetence after surgery in patients with cleft palate.
著者
森本 真弘 浅香 卓哉 鎌口 真由美 山下 映美 坂田 健一郎 大内 学 大賀 則孝 佐藤 淳 佐藤 千晴 北川 善政
出版者
公益社団法人 日本口腔外科学会
雑誌
日本口腔外科学会雑誌 (ISSN:00215163)
巻号頁・発行日
vol.65, no.7, pp.447-454, 2019-07-20 (Released:2019-09-20)
参考文献数
22
被引用文献数
2

Palmoplantar pustulosis (PPP) is a refractory skin disorder exhibiting numerous sterile pustules on the palms and soles of the patients. PPP is related to dental focal infection and metal allergy, and the experts in dermatology and dentistry have worked together to arrive at a consensus regarding the diagnosis and treatment of PPP. However, the obvious cause of PPP remains unknown, and a standard treatment has yet to be established. In this study, we aimed to clarify the relation of PPP to dental focal infection and dental metal allergy. We evaluated 29 patients with PPP who underwent oral examination and patch testing in the Department of Oral Medicine at Hokkaido University Hospital from July 2010 through May 2014. In total, 22 of the 29 patients had positive patch test results, and flare-up was observed in one patient. Metallic component analysis revealed that the oral cavity was metal-positive in 14 of 22 patch test-positive patients. In contrast, odontogenic foci were found in 25 of 29 patients. Among 14 patients who had positive patch-test results for metal in the oral cavity, the course after metal removal could be confirmed in nine patients, and skin symptoms improved in all patients. Among 15 patients who did not have patch-test results for metal in the oral cavity, the course after treatment of odontogenic foci could be confirmed in eight patients, and symptoms improved in only one patient. This study resulted in a higher rate of improvement after removal of dental metals versus treatment of odontogenic foci, suggesting that PPP strongly correlates with dental metal allergy. However, because odontogenic foci may be treated concurrently with metal removal, an association between PPP and dental focal infection cannot be denied. In addition to the time and cost burden of metal removal, symptoms may improve naturally in some cases. Therefore, we suggest that it is necessary to consider the suitability of metal removal on a case-by-case basis.
著者
青柳 信好 黒田 卓 大石 建三 佐野 寿哉 連 利隆
出版者
Japanese Society of Oral and Maxillofacial Surgeons
雑誌
日本口腔外科学会雑誌 (ISSN:00215163)
巻号頁・発行日
vol.53, no.8, pp.481-485, 2007-08-20 (Released:2011-04-22)
参考文献数
13
被引用文献数
1

We report a case of serious injury to the oral mucosa resulting from the ingestion of a chemical agent.The severity of chemical injury to tissue depends on several factors, including the amount of agent involved, theduration of exposure, and the location of the affected site. It is important to immediately identify the cause ofchemical burns and to administer treatment quickly as damage will continue even after the chemical agent hasbeen removed.A 32-year-old man with schizophrenia swallowed sodium hydroxide in an attempt to commit suicide and wasbrought to our emergency room. An oral examination showed bilateral erosion of the buccal mucosa, soft palate, tongue, and lips. A tracheotomy was performed because of airway stenosis. The patient was instructed to garglewith azulene sodium sulfonate and to apply ointment on his lips. After 2 weeks, his condition improved and he wasdischarged from the hospital. Scar revision and skin grafting were performed as the patient was unable to movehis tongue for 5 months because of scar contracture of the sublingual region.
著者
竹之下 康治 堀之内 康文 山本 昌家 平野 裕士 岡 増一郎 岡本 学
出版者
Japanese Society of Oral and Maxillofacial Surgeons
雑誌
日本口腔外科学会雑誌 (ISSN:00215163)
巻号頁・発行日
vol.35, no.1, pp.187-191, 1989-01-20 (Released:2011-07-25)
参考文献数
19
被引用文献数
3 3

Fracture of the mental spine (genial tubercles, spina mandibularis) is comparatively rare entity of mandibular fracture. It can be assertained only by occlusal radiogram. This type of fracture is considered that normal occlusal stress is a main role, in the severely atrophied edentulous mandible and hypertrophied spines in the denture bearing elders.The pathogenesis of this fracture is proposed as one of the stress or spontaneous fractures, like a so-called pathologic fracture. In this sequence, the dental practitioners should keep in mind the possibility of this fracture, especially in denture construction.The authors reported three further cases treated conservatively and discussed the mechanism and treatment of this injury.
著者
村岡 渡 井川 雅子 今井 昇 池内 忍 朝波 惣一郎 中川 種昭
出版者
Japanese Society of Oral and Maxillofacial Surgeons
雑誌
日本口腔外科学会雑誌 (ISSN:00215163)
巻号頁・発行日
vol.50, no.10, pp.585-588, 2004-10-20 (Released:2011-04-22)
参考文献数
19
被引用文献数
1 2

Temporal arteritis, also referred to as giant cell arteritis, is a rare disease in Japan. The epidemiological investigation performed by the Ministry of Health and Welfare in Japan in 1998 reported that temporal arteritis occurred at a frequency of 0.65 cases per 100, 000 population. The first symptoms, according to this report, were headache, usually in the temporal region, accompanied by fever, weight loss, and visual disturbance.A 78-year-old woman with temporal arteritis who had a chief complaint of jaw claudication is reported. Her symptoms at first consultation were bilateral temporal tenderness, funicular swelling of the superficial temporal artery, and an increased erythrocyte sedimentation rate. Because temporal arteritis was suspected, the patient was referred to a neurologist. After admission to the department of neurology, the right temporal artery showed an embolus on digital subtraction angiography and the left temporal artery showed constriction; a biopsy of the right temporal artery was therefore performed by an otolaryngologist. Histopathological examination showed a granulomatous inflammatory lesion with mononuclear cell infiltration associated with Langhans' type giant cells, involving mainly the tunica intima. By the early diagnosis of temporal arteritis and immediate steroid administration, these symptoms markedly improved within 48 hours, and no signs or symptoms have been observed subsequently.
著者
藤城 建樹 荘司 洋文 北詰 栄里 岡村 尚 吉田 和正 辺見 卓男
出版者
公益社団法人 日本口腔外科学会
雑誌
日本口腔外科学会雑誌 (ISSN:00215163)
巻号頁・発行日
vol.64, no.8, pp.486-491, 2018-08-20 (Released:2018-10-22)
参考文献数
15

If the inferior alveolar nerve is resected by surgery for a mandibular tumor, the perception of its dominant area will be permanently lost. When we perform nerve reconstruction, autologous nerve grafting is usually performed, but there is a fault that we produce new neuropathy in the nerve-donor site. The nerve conduit, which is an artificial material, begins to be used for nerve amputation and deficiency, but there is no report about mandibular tumors. The patient was a 20-year-old man with mandibular ameloblastoma. We performed hemimandibulectomy, mandibular reconstruction with a free iliac bone graft, and inferior alveolar nerve reconstruction with a nerve conduit. The postoperative course was uneventful. Neurosensory disturbance of the mental nerve improved 5 months after surgery, and approximately normally status was recovered after 10 months. Currently, 2 years have passed since the operation, and there are no obvious abnormalities.
著者
横林 敏夫 横林 康男 中島 民雄
出版者
Japanese Society of Oral and Maxillofacial Surgeons
雑誌
日本口腔外科学会雑誌 (ISSN:00215163)
巻号頁・発行日
vol.30, no.9, pp.1338-1347, 1984-09-20 (Released:2011-07-25)
参考文献数
18
被引用文献数
3 2

Clinical, radiographic and histologic features of 6 recurrent odontogenic keratocysts that developed in 5 patients were described.The rate of recurrence in 28 cases with a minimum of one year follow-up was 21.4% that corresponded well to the average rate reported in other studies. The recurrence was noted 9 months to 5 years after treatment. The results indicated the necessity of regular and long-term follow-up because of the absence of symptoms associated with recurrence in most cases. The mean age of the patients was 16.6 years which was significantly lower than that of patients wthout recurrence.Radiographically, the lesions were unilocular in 4 cases with smooth or scalloping borders and multilocular in other cases. Three cases manifested themselves as huge radiolucent lesions extending from the molar area to the mandibular notch. The initial lesions were also extending over 5 teeth in 2 of 3 cases that developed in the tooth bearing area, but the huge size was not the findings characteristic of the recurrent cases. The cysts were associated with impacted teeth in 5 cases, but the condition could not be regarded as the cause of recurrence. In terms of location, there was no predilecton in the site of recurrence.Five of the 6 cysts had been treated by marsupialization followed by enucleation and primary closure, whereas recurrence was found in no case in which marsupialization, marsupialization followed by enucleation and packing open, enucleation and packing open or block resection were performed. Thus, treatment modality was the most important prognostic factor. Because of the various advantages of marsupialization, we are still in favor of the procedure in the treatment of the cyst occurring in young patients. When enucleation should be considered after marsupialization, however, the utmost care should be taken to remove the cyst en bloc with a margin of safety to include the soft tissue over the areas of bony defect and a layer of the surrounding bone to which it may be adhered and leave the wound to heal secondarily.The presence of epithelial islands or daughter cysts in the cystic wall could not be correlated the recurrence.